The state of the clerkship: a survey of emergency medicine clerkship directors.

OBJECTIVES

An emergency medicine (EM) clerkship can provide a medical student with a unique educational experience. The authors sought to describe the current experiential curriculum of the EM clerkship, along with methods of evaluation, feedback, and grading.

METHODS

A descriptive survey was utilized. Clerkship directors at EM residency programs accredited by the Accreditation Council for Graduate Medical Education completed an online questionnaire. Data were analyzed using descriptive statistics.

RESULTS

Ninety-two (70%) of 132 EM clerkship directors completed the survey. Sixty institutions (65%) accepted only fourth-year medical students, and 35% accepted both third- and fourth-year students. The median number of didactic lecture hours provided during each rotation block for students was ten (interquartile range [IQR], 6-16). The average length of a student's clinical shift was eight hours, while the median number of clinical shifts reported per rotation was 15 (IQR, 14-16). The median number of hours worked weekly by a medical student was 40 (IQR, 35-43). Fifty-four EM clerkship directors (59%) incorporated the Accreditation Council for Graduate Medical Education six core competencies into their evaluation process. Seventy-one clerkship directors (77%) used a shift evaluation card to evaluate the clinical performance of medical students. Fifty-four (59%) incorporated an end-of-rotation written examination to determine the final rotation grade for a medical student.

CONCLUSIONS

Medical students are exposed to a variety of didactic lectures and procedure labs but have similar experiences regarding shift length and work hours. Methods of evaluation of clinical performance vary across clinical sites.